Haggling with your Health Insurance Company

My husband and I were recently in a battle with our health insurance provider,
United HealthCare, over a claim they denied during my pregnancy—to the tune of
more than $200. It was an expensive prescription that was required due to my
blood type, and we appealed, working our way through a maze of phone
representatives and wrong answers. We eventually triumphed (they reimbursed us
for the full amount), but it was a painful process, and it would’ve been easy to
give up.

Although appealing a health claim denial is rarely simple, there are ways to
ensure that you don’t get lost in the system (or at least, not too lost).
Rebecca Stephenson, co-president of the Alliance of Claims Assistance Professionals, has these tips:

Take good notes. Keep a record of the date and time of your call and
who you talked to. Get the rep’s extension, if she’ll give it to you, and a last
name. Maybe you spoke to Jane, who told you she’d take care of it, but she
didn’t, and there are 12 Janes there. Get a last initial, at the very least.

Don’t procrastinate. Say you’ve been getting notices about a medical
bill for six months and you’ve been putting off dealing with it. If your policy
requires you to appeal a denial within 60 to 90 days, it might be too late. As
soon as your health insurance company denies something that you think it should
pay, make the phone call.

Keep your policy on hand. When you receive new health insurance, you
should also get a booklet that explains exactly what your policy covers. Keep it
someplace handy, because it’s the only ammo you have when you’re tackling
claims. Insurance websites often don’t have much more than bare-bones
info, and phone reps may or may not give you the correct answers. If you don’t
have a booklet, contact your benefits department to see if they can get one for
you.

Hire help if you need it. You’re probably not going to want to hire
assistance for a $200 bill. But if you’re dealing with thousands of dollars of
claims from something huge, such as cancer, know that there are specialists out
there who can help you. Start with claims.org to find a claims assistance
professional near you.

Have you ever wrangled with your insurance company over a claim?